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Facility Evaluation Report

Kings Rehabilitation Center, INC., Hanford03/25/2025Licence 160403663

Capacity100
Census17
Date signed04/04/2025 08:55:51 AM
Name of licensing program analystJacques Leffall
Name of licensing program managerSee Moua
The inspector’s account

On 3/25/25, Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and met with Administrator (A1) Susan Acosta. 11 clients were present during inspection. LPA conducted facility tour with A1.

LPA toured the facility. All passageways and exits were clear and free from obstruction. Facility was at

comfortable temperature maintained at 68 degrees F. The Day Program has 5 classrooms. LPA toured the art room, media room, gym, music room, recreational room for special activities, game room and kitchen. All classrooms and activity areas were clean and odor free. Kitchen is used to make breakfasts and lunches for clients. Food was observed to be stored in refrigerator and freezer. Client’s bathrooms were observed clean, and fixtures were functioning properly. Cleaning supplies observed stored and locked in supply closet. Facility quiet room and changing room was toured. Fire extinguisher observed throughout the facility with a serviced date 4/5/2024. Carbon monoxide was tested and observed to be operational. Fire drill last completed 3/6/25. Samples of client files reviewed to have all of the required documents. 1 out of 4 staff was missing 1 required document. First Aid/CPR, fingerprinted clear and associated to the facility. 3 bathrooms water temperature measured at a range of 105.6 to 114.9 degrees F. Technical Support Services were recommended and accepted by facility.

The following deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6.

Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 4/8/25: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A)

A copy of this report with Appeal Rights were provided to A1, whose signature on this form confirms receipt of this report.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction